Chinese consensus on the clinical application of hepatobiliary magnetic resonance imaging contrast agent: Gadoxetic acid disodium

Rao, Sheng-Xiang; Wang, Jin; Wang, Jian; Jiang, Xin; Li, Zi Ping; Li, Zhen Lin; Shen, Wen; Zhao, Xin; Hu, Dao Yu; Zhang, Hui Mao; Zhao, Lin; Yi, Huan; Liang, Chun; Song, Bin; Zeng, Meng Su

doi:10.1111/1751-2980.12707

Cited by 10 publications

(9 citation statements)

References 64 publications

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“…The detection rate for liver tumors ≤1.0 cm diameter and the accuracy of diagnosis and differential diagnosis of HCC are improved by using the hepatocyte-specific MRI contrast agent gadoxetic acid disodium (Gd-EOB-DTPA) [11][12][13][14][15] (level 2 evidence). Compared with dynamic contrast-enhanced CT, multimodal MRI is superior for evaluating involvement of the portal vein, and main trunk and branches of the hepatic vein, as well as identifying abdominal or retroperitoneal lymph node metastases.…”

Section: Imaging Examinations For Hccmentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2019 Edition)

et al. 2020

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Background: Primary liver cancer, around 90% are hepatocellular carcinoma in China, is the fourth most common malignancy and the second leading cause of tumor-related death, thereby posing a significant threat to the life and health of the Chinese people. Summary: Since the publication of Guidelines for Diagnosis and Treatment of Primary Liver Cancer (2017 Edition) in 2018, additional high-quality evidence has emerged with relevance to the diagnosis, staging, and treatment of liver cancer in and outside China that requires the guidelines to be updated. The new edition (2019 Edition) was written by more than 70 experts in the field of liver cancer in China. They reflect the real-world situation in China regarding diagnosing and treating liver cancer in recent years. Key Messages: Most importantly, the new guidelines were endorsed and promulgated by the Bureau of Medical Administration of the National Health Commission of the People’s Republic of China in December 2019.

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Section: Imaging Examinations For Hccmentioning

confidence: 99%

Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2019 Edition)

et al. 2020

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“…Besides, the exact time of image acquisition may affect the maximal diameter measured in arterial phase, and LI-RADS v2018 recommends the diameter should be measured in non-arterial phases if possible. Moreover, during gadoxetic acid-enhanced MRI, 10%-20% of the patients had acute short-term dyspnea in the early stage of the artery, which made it difficult for the patients to hold their breath, resulting in transient severe respiratory motion artifacts and seriously affecting the image quality in arterial phase (29). Therefore, the arterial phase may not be the best choice to measure the size of the HCC using gadoxetic acidenhanced MRI.…”

Section: Discussionmentioning

confidence: 99%

Hepatobiliary phase images of gadoxetic acid-enhanced MRI may improve accuracy of predicting the size of hepatocellular carcinoma at pathology

et al. 2021

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Background Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has been widely used in clinical practice. However, scientific evidence is lacking for recommending a particular sequence for measuring tumor size. Purpose To retrospectively compare the size of hepatocellular carcinoma (HCC) measured on different gadoxetic acid-enhanced MRI sequences using pathology as a reference. Material and Methods A total of 217 patients with single HCC who underwent gadoxetic acid-enhanced MRI before surgery were included. The size of the HCC was measured by two abdominal radiologists independently on the following sequences: T1-weighted; T2-weighted; b-500 diffusion-weighted imaging (DWI); and arterial, portal venous, transitional, and hepatobiliary phases. Tumor size measured on MRI was compared with pathological size by using Pearson correlation coefficient, independent-sample t test, and Bland–Altman plot. Agreement between two readers was evaluated with intraclass correlation coefficient (ICC). Results Correlation between the MR images and pathology was high for both readers (0.899–0.955). Absolute error between MRI and pathologic assessment was lowest on hepatobiliary phase images for both readers (reader 1, 2.8±4.2 mm; reader 2, 3.2±3.4 mm) and highest on arterial phase images for reader 1 (4.9±4.4 mm) and DWI phase images for reader 2 (5.1±4.9 mm). Absolute errors were significantly different for hepatobiliary phase compared with other sequences for both readers (reader 1, P≤0.012; reader 2, P≤0.037). Inter-reader agreements for all sequence measurements were strong (0.971–0.997). Conclusion The performance of gadoxetic acid-enhanced MRI sequences varied with HCC size, and the hepatobiliary phase may be optimal among these sequences.

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“…The number of literatures retrieved from the above databases is 962, 380, 384, 132. We excluded articles that were not related to Gd-EOB-DTPA-enhanced MRI HBP acquisition, Finally, a total of 12 articles and the Liver Imaging Reporting and Data System (LI-RADS) version 2018 on the clinical application of liver-specific contrast agents Gd-EOB-DTPA were obtained (Tables 2,3) (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Methods Of the Studymentioning

confidence: 99%

“…Whether a delayed HBP acquisition will benefit patients with severe cirrhosis is also controversial. In clinical practice, we tend to postpone HBP collection time in patients with cirrhosis (21).…”

Section: Methods Of the Studymentioning

confidence: 99%

Optimization of hepatobiliary phase imaging in gadoxetic acid-enhanced magnetic resonance imaging: a narrative review

Wang¹,

Yuan²,

Wu³

et al. 2023

Quant Imaging Med Surg

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Background and Objective: Gadolinium ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) is widely used in clinical practice. Its unique hepatobiliary phase (HBP) has been used to improve the detection and identification of hepatic lesions and has also been used to evaluate hepatic function and fibrosis. At the early stage of its clinical practice, the HBP was typically collected empirically with a delay of 20 minutes after intravenous administration to image the liver with sufficient enhancement for diagnosis. However, numerous methods and consensus statements for optimizing HBP acquisition have been proposed. This review details the methods and consensus statements on optimizing HBP collection.Methods: The electronic literature search was performed using the databases PubMed, MEDLINE, Cochrane, and Embase without limit on publication period to identify published reports on optimizing HBP imaging in Gd-EOB-DTPA-enhanced MRI. Articles with low relevance to the topics were excluded.Key Content and Findings: Recently, an increasing number of investigations suggest that collecting HBP after 20 min is too drawn-out for patients with normal liver function but is too short for patients with cirrhosis. Previous studies demonstrated that liver enhancement is closely related to liver function in Gd-EOB-DTPA-enhanced MRI. Therefore several reports have proposed various HBP delay times at different liver function levels. These delay times could be evaluated by laboratory indicators, such as prothrombin (PT) activity, total bilirubin, direct bilirubin, and the model for end-stage liver disease. Other investigations have found that the initial visualization time of the intrahepatic bile duct (IHD) in Gd-EOB-DTPA-enhanced MRI to also be related to liver enhancement and function. Therefore, initial visualization of the IHD is considered necessary for adequate HBP and has been employed in HBP acquisition in recent reports. Conclusions:Optimizing HBP acquisition according to individual hepatic function is a good strategy and was followed in most of the investigations included in our review. Obtaining adequate HBP in the shortest possible time is the target condition in Gd-EOB-DTPA-enhanced MRI. However, a more concise and efficient HBP acquisition strategy is still expected to be developed in the future.

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Chinese consensus on the clinical application of hepatobiliary magnetic resonance imaging contrast agent: Gadoxetic acid disodium

Cited by 10 publications

References 64 publications

Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2019 Edition)

Guidelines for the Diagnosis and Treatment of Hepatocellular Carcinoma (2019 Edition)

Hepatobiliary phase images of gadoxetic acid-enhanced MRI may improve accuracy of predicting the size of hepatocellular carcinoma at pathology

Optimization of hepatobiliary phase imaging in gadoxetic acid-enhanced magnetic resonance imaging: a narrative review

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